ESTRO 2024 - Abstract Book

S2427

Clinical - Urology

ESTRO 2024

pre-RP PSA (continuous variable). Interactions with treatment group were included for entry-level PSA, Gleason score, margin status, age, and performance status if significant at the 0.10 level. Additionally, subgroups based on entry-level PSA, Gleason score, margin status, age, and performance status were examined.

Results:

Two published randomized trials met the inclusion criteria: NRG/RTOG 0534 and GETUG-AFU 16. We excluded patients who received pelvic RT because all of them received ADT on RTOG 0534. Thus, a total of 1,791 patients were included with a median follow-up of 8.4 years. STADT improved MFS (5-year absolute benefit: 4.3%, HR=0.78, 95% CI: 0.63-0.96, p=0.02) on unadjusted analysis. Older age, higher Gleason score, negative margins, PSA >=0.3, and SVI were all associated with worse MFS on multi variable analysis. Except for time between RP and SRT, interaction tests did not indicate a significant differential benefit in any covariate. At 3.3 years from RP to SRT, STADT had improved MFS compared to RT only (HR 0.75, 95% CI: 0.60-0.92, p=0.02). Subgroup analysis showed that the greatest MFS benefit from STADT was in patients with PSA >=0.3 (vs. <0.3), positive margins (vs negative), and ECOG PS=0 (vs PS=1). STADT had no impact on OS (HR 0.90, 95% CI: 0.69-1.18, p=0.45). Older age, higher Gleason score, ECOG PS, and SVI were all associated with worse OS on multi-variable analysis. Except for ECOG PS, interaction tests did not indicate a significant differential benefit in any covariate. In patients who received STADT, those with ECOG 1 had worse OS than ECOG 0 (HR=2.24, 95% CI: 1.25-4.04). OS was not different in patients with ECOG 0 or 1 in patients who received RT alone. None of the groups tested in subgroup analysis showed differential OS benefit to STADT.

Conclusion:

Our findings from this individual patient data pooled analysis of NRG/RTOG 0534 and GETUG-AFU 16 shows an MFS benefit from STADT with SRT. The impact of STADT on OS was dependent on ECOG performance status, suggesting effects from deaths due to intercurrent illness in those with poor PS.

Keywords: Prostate cancer, salvage radiotherapy, ADT

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Sofia Spampinato 1 , Marta Pelizzola 1 , Tiziana Rancati 2 , Justyna Magdalena Waskiewicz 3 , Barbara Avuzzi 4 , Elisabetta Garibaldi 5 , Adriana Faiella 6 , Elisa Villa 7 , Alessandro Magli 8 , Domenico Cante 9 , Giuseppe Girelli 10 , Marco Gatti 11 , Barbara Noris Chiorda 4 , Luciana Rago 12 , Paolo Ferrari 13 , Cristina Piva 9 , Maddalena Pavarini 14 , Elena Celia 5 , Vittorio Vavassori 7 , Fernando Munoz 5 , Giuseppe Sanguineti 6 , Nadia Di Muzio 15 , Kathrin Kirchheiner 16 , Claudio Fiorino 14 , Cesare Cozzarini 17